Pack system for a small ophthalmic unit.
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Eye Diseases↗
Biomedical subjects
M Jenkins
Publications and source records attributed to M Jenkins.
Studies with DNA-cellulose chromatography. I. DNA-binding proteins from Escherichia coli.
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Bacteriophages↗
Migrant farmworker children: health status, barriers to care, and nursing innovations in health care delivery.
Migrant farmworkers are one of the most health care-impoverished populations in the United States. Mobility, hazardous occupations, cultural diversity, and low socioeconomic status place migrants, and particularly migrant children, at high risk for inadequate health care and preventable health problems. This article presents a synthesis of the existing research on migrant demographics, major health risks, and geographic, financial, and cultural barriers to health care access. Innovative nursing strategies to enhance access and improve the health of migrant children are explored. These include the use of lay community outreach workers, the creation of alternative health care delivery models, and the development of information tracking systems.
Agriculture↗
String vibration dampers do not reduce racket frame vibration transfer to the forearm.
In this study, we examined the effect of string vibration damping devices on reducing racket frame vibration transfer to the forearm. Twenty participants volunteered to hold a tennis racket stationary in a forehand and backhand stroking position while tennis balls were fired at 20 m x s(-1) towards two impact locations, the node of vibration and the dead spot. A three-way analysis of variance with repeated measures on damping condition, impact location and stroke condition was performed on the data. The resonant frequency of the hand-held racket was found to be approximately 120 Hz. No significant differences in amplitude of vibration at the resonant frequency were found for the wrist or the elbow when damped and non-damped impacts were compared. Impacts at the dead spot produced greater amplitudes of vibration (P < 0.01) but no interaction between impact location and string dampers was evident. The string dampers had no effect on the grip force used or the muscle electrical activity in the forearm after impact. In conclusion, we found that string dampers do not reduce the amount of racket frame vibration received at the forearm. We suggest that string dampers remain a popular accessory among tennis players because of their acoustic effects and psychological support rather than any mechanical advantage.
Adult↗
Failure of topical steroids and vitamin E to reduce postoperative scar formation following reconstructive surgery.
One hundred fifty-nine operative procedures for postburn contractures of interdigital webs (96), the axilla (46), or the neck (17) were prospectively randomized to be treated postoperatively for four months with a topical steroid (Aristocort A), topical vitamin E, or the base cream carrier for these drugs. The nature of the medication was blinded both to the patient and to the evaluator. Patients were followed for one year. Observations were made for range of motion, scar thickness, change in graft size, and ultimate cosmetic appearance. No beneficial effect of either vitamin E or topical steroid could be demonstrated. However, adverse reactions occurred in 16.4% of patients receiving active drug, compared to 5.9% treated only with base cream. Interestingly, the grafts initially contracted and subsequently grew to be a size larger (about 20%) than the original graft by one year. It is concluded that neither topical steroid nor topical vitamin E is effective in reducing scar formation after grafting procedures for reconstruction for postburn contractures.
Administration, Topical↗
Effect of ibuprofen on the postburn hypermetabolic response: a case report.
Severely burned patients exhibit a postburn hypermetabolic response which, with the most severe burns, can double the patient's metabolic rate. We report on a 54-year-old man who was on long-term ibuprofen administration for treatment of arthritis before sustaining a 38% total body surface area burn. This patient failed to demonstrate the normal hypermetabolic response. The possibility that the ibuprofen administration prevented the hypermetabolic response is discussed.
Arthritis↗
Pediatric patients experiencing postoperative nausea and vomiting after burn reconstruction surgery: an analysis.
Nausea and vomiting after a surgical procedure has a significant impact on a patient's hospital course. A perceived increased incidence of postoperative nausea and vomiting (PONV) in pediatric patients undergoing reconstructive scalp surgery had been clinically observed. A chart review to determine if a relationship existed between the surgical procedure and the incidence of PONV was conducted by selecting patients who were 5 to 12 years old and whose surgery fell between April 1995 and August 1995. Thirty-eight patients were evaluated for 46 procedures; 8 patients were evaluated for both insertion and removal of scalp expanders. No differences were identified between groups for previous history of PONV, length of anesthesia, or position during surgery. Data from the retrospective review suggested that pediatric patients with reconstructive surgeries of the scalp experienced PONV at 100% (24 procedures), whereas only 45% (10 procedures) of patients whose surgeries did not involve the scalp experienced PONV. In addition, despite significant earlier return of bowel sounds, episodes of PONV and time to oral intake were also increased in the group of patients whose operations involved the scalp. On the basis of these findings, a prospective study has been initiated to determine if changes in the perioperative protocol will improve patient outcomes and reduce the incidence of PONV.
Burns↗
American Burn Association/Shriners Hospitals for Children burn outcomes questionnaire: construction and psychometric properties.
To develop a standardized, practical, self-administered questionnaire to monitor pediatric patients with burns and to evaluate the effectiveness of comprehensive pediatric burn management treatments, a group of experts generated a set of items to measure relevant burn outcomes. Children between the ages of 5 and 18 years were assessed in a cross-sectional study. Both parent and adolescent responses were obtained from children 11 to 18 years old. The internal reliability of final scales ranged from 0.82 to 0.93 among parents and from 0.75 to 0.92 among adolescents. Mean differences between parent and adolescent were small; the greatest difference occurred in the appearance subscale. Parental scales showed evidence of validity and potential for sensitivity to change. In an effort to support the construct validity of the new scales, they were compared with the Child Health Questionnaire and related to each other in clinically sensible ways. These burn outcomes scales reliably and validly assess function in patients with burns, and the scales have been developed in such a way that they are likely to be sensitive to change over time.
Activities of Daily Living↗
Nutritional aspects of the orthopaedic trauma patient.
The metabolic response to trauma is related to a variety of factors, including severity of injury, age, and previous state of health and nutrition (Cardona et al., 1994). This article addresses nutritional considerations of an orthopaedic trauma patient. A case study has been developed with common findings associated with malnutrition, including postoperative infection. Three concepts are discussed: (a) pretrauma nutritional status, (b) post-trauma metabolism, and (c) nutritional assessment parameters. A brief comment on nursing diagnoses related to nutrition concludes this article.
Adult↗
Diarrhea in tube-fed burn patients: incidence, etiology, nutritional impact, and prevention.
The hypermetabolic state observed in thermally injured patients warrants aggressive nutritional management. Enteral support is the preferred route of nutrient delivery, however diarrhea is reported to be a persistent complication of continuous nasogastric or nasoduodenal hyperalimentation. Diarrhea adds to problems in patient care, disturbs fluid and electrolyte balance, and worsens nutritional status. There has been the impression that tube feeding hyperosmolality, antibiotics, and low serum albumin induce diarrhea. However, in view of the sparsity of published work, a prospective study was undertaken to determine the incidence of diarrhea and to define factors associated with its cause. Of the 50 patients studied, 16 (32%) developed diarrhea. Stool cultures were negative for pathogenic organisms. Although the risk of diarrhea was associated with antibiotics (p less than 0.005), several nutrients also had an impact. Results demonstrated a significant relationship between dietary lipid content (p less than 0.05) or vitamin A intake (p less than 0.001) and diarrhea. Implementation of tube feeding within 48 hrs postburn was also associated with a decreased incidence of diarrhea (p less than 0.001). This paper describes a modular tube feeding program in which diarrheal frequency is lessened (p less than 0.0001). Surprisingly, tube feeding osmolality, drugs used to prevent stress ulcers, or hypoalbuminemia did not have an adverse effect on intestinal absorption. The cause of diarrhea in burn patients is obviously multifactorial. It is concluded that a low fat (less than 20% of caloric intake), vitamin A enriched (greater than 10,000 IU/day), early enteral support program maximizes conditions which promote tube feeding tolerance while minimizing nutrient malabsorption during the nutritional rehabilitation of thermal injury.
Adolescent↗
Differential effects of three enteral dietary regimens on selected outcome variables in burn patients.
A modular tube feeding recipe (MTF) was designed to meet the unique nutritional needs of burn patients, applying principles previously documented in our burned guinea pig model. MTF, a high-protein, low-fat, linoleic acid-restricted formulation is enriched with omega-3 fatty acids, arginine, cysteine, histidine, vitamin A, zinc, and ascorbic acid. Fifty patients, 3 to 76 years of age with burns ranging from 10 to 89% total body surface area were prospectively randomized into three groups which blindly compared MTF to two enteral regimens widely utilized in the nutritional support of burns. Age, percent total and third-degree burn, resting energy expenditure, and calorie and protein intake were similar in all groups. Data analysis demonstrated significant superiority of MTF in the reduction of wound infection (p less than 0.03) and length of stay/percent burn (p less than 0.02). MTF was also associated with a decreased incidence of diarrhea, improved glucose tolerance, lower serum triglycerides, reduced total number of infectious episodes and trends toward improved preservation of muscle mass, although statistical significance was not achieved. Seventy percent of deaths occurred in the group supported with an inherently large dose of fat and linoleic acid. Combining these observations, it is believed that MTF is effective in modulating an improved response to burn injury.
Adolescent↗
PAT: advanced nursing interventions for eating disorders.
Passive activity time (PAT) is a nursing intervention that was developed for young people with eating disorders. This development was a pioneering attempt to examine the nursing care for this client group and improve treatment programmes. Nursing practice before PAT was dominated by a biomedical model which directed a set procedure of care for all patients, focusing primarily on weight restoration. The prominent interventions were bed rest for any patient who was under weight and a strict dietary regimen. PAT was the result of a change in nursing practice towards a more holistic philosophy of care. This article will describe the rationale behind its development and discuss its potential in future nursing practice for people experiencing anorexia nervosa.
Activities of Daily Living↗
Infection control. Gloves to fit the bill.
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Catheters, Indwelling↗
The prognostic value of nutritional and inflammatory indices in patients with burns.
The Prognostic Inflammatory and Nutritional Index (PINI = [alpha 1-acid glycoprotein x C-reactive protein] divided by [albumin x prealbumin]) has been proposed as a means of predicting morbidity or mortality in hospitalized patients. This study compared the efficacy of the PINI versus its individual determinants as potential prognostic indicators of infection or death in patients with burns. Laboratory data from postburn days 7 to 10 were evaluated in a series of 60 patients who had a mean total body surface area (TBSA) burn of 44.7% (range 10% to 81%) and a mean age of 18.9 years (range, 0.5 to 71 years). Survivors had a mean TBSA burn of 42.9%, whereas patients who subsequently died had a mean TBSA burn of 51.8% (not significant). Percent third-degree burn and alpha 1-acid glycoprotein were likewise not related to the mortality rate. We found the PINI to be associated with death (p less than 0.0003), as were the variables C-reactive protein (p less than 0.0002), prealbumin (p less than 0.0001), and albumin (p less than 0.03). Thirty-six patients had infectious complications that were statistically related to percent burn (p less than 0.02), percent third-degree burn (p less than 0.003), alpha 1-acid glycoprotein (p less than 0.05), prealbumin (p less than 0.0009), and the PINI (p less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Adjusting to chronic dialysis--a patient's view.
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Adaptation, Psychological↗
Infection control. When winter makes you sick.
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Caliciviridae Infections↗
Early extubation post-cardiac surgery--implications for nursing practice.
Early extubation of patients after cardiac surgery is becoming widely accepted as a means of improving patient care. Nurses working in cardiac surgery appear to be one group who are best placed to manage this role as a component of holistic care and to develop their potential. It appears that benefits include short recovery and early discharge as well as reduced health service costs with a larger throughput of patients undergoing cardiac surgery. Patient selection of those suitable for early extubation requires the implementation of multidisciplinary protocols to ensure quality and effectiveness of care. Nurses need to re-examine their current practice in order to identify the changes required to develop evidence-based post-operative care.
Clinical Protocols↗